AB1494 THE QUALITY OF REPORTING IN RANDOMIZED CONTROLLED TRIALS OF BALANCE EXERCISES IN TOTAL KNEE ARTHROPLASTY
Authors: D. Ozcan, T. Ünver, B. Unver
Journal: Annals of the Rheumatic Diseases (2022)

Background Total knee arthroplasty (TKA) is used to treat patients with end-stage osteoarthritis who experience pain and struggle to perform activities of daily living owing to having degenerative knee joints. Although TKA can improve the quality of life of patients, some may experience a decrease in their proprioception and the ability to balance after surgery (1). Decreased balance ability makes it difficult to undertake daily life activities in patients after TKA, impairs walking capacity and increases the risk of falling (2). Almost all studies which investigate the risk of falling conclude that physical activity(PA) are effective methods in order to maintain an intact balance control and prevent falls(4). Today, however, measures aimed at controlling COVID-19 include quarantines that lead to PA restrictions (5). In these days when PA cannot be increased due to quarantines, the most effective way to prevent falls in TKA patients may be to apply balance exercises (3). The “gold standard” in clinical trials are randomized controlled trials(RCTs) in which healthcare professionals make decisions about the safety and efficacy of treatments. However, poorly designed and reported RCTs can give misleading results. Methodological quality (MQ) assessment of clinical trials is important because it can prevent erroneous results in clinical practice and improve the quality of medical care. (6) Although RCTs provide the highest quality clinical evidence selection of balance exercises(BE) to be applied, there is no study in the literature investigating the MQ of RCTs of BE in TKA patients. Objectives The aim was to investigate assess the reporting MQ of RCTs of BE in patients with TKA. Methods We analyzed 17 published full-text reports of RCTs using BE in patients who underwent TKA. RCTs were sourced from PubMed, the Cochrane Reviews and PEDro Database. The PEDro scale and the 9-item CONSORT (7) were used to evaluate the MQ of the studies. Results The mean PEDro score was 6,64 ± 1,57. Classification of RCTs according to total PEDro score revealed that 1 study was classified as excellent, 13 studies as good, and 3 as fair. The least fulfilled criteria in the PEDro scale were: Blinding of all therapists who administered the therapy (1[5.88%]), allocation was concealed (5[29.4%]) and blinding of all subjects (7[41.17%]). The adherence of the reports to CONSORT items ranged from 41.17 % to 100%. The most underreported CONSORT items were: funding sources (7[41.17%]), statistical adjustment for multiple primary outcomes (8[47.05%]), and number of primary outcomes (8[47.05%]). Conclusion Our findings show that the quality of reporting for RCTs of BE in TKA patients is not high quality. Since it is not possible to improve balance with PA today, when there are quarantine due to COVID-19, patients should be encouraged to participate in BE programs with telerehabilitation, home-based or web-based exercises, and high quality RCTs should be planned in these programs. References [1]Lee, H. G., et al International journal of environmental research and public health, 2021;18(5), 2513. [2]Matsumoto H, et al. Arch Orthop Trauma Surg. 2012;132(4):555–63. [3]Doma K, et al. Sports Med. 2018 Oct;48(10):2367-2385. [4]Thomas, E., et al. Medicine, 2019; 98 (27), e16218. [5]Füzéki, E., et al. Journal of occupational medicine and toxicology (London, England), 2020;15, 25. [6]McCormick F, et al. J Shoulder Elbow Surg. 2013 Sep;22(9):1180-5 [7]Gonzalez GZ, et al. Arch Phys Med Rehabil. 2018 Jan;99(1):129-136. Disclosure of Interests None declared